[1]陈天佑,袁 敏,杨柏帅,等.经左侧腋静脉近侧段植入输液港穿刺方式临床研究[J].介入放射学杂志,2021,30(12):1286-1291.
　CHEN Tianyou,YUAN Min,YANG Boshuai,et al.Implantation of totally implantable venous access port via left proximal axillary venous approach： a clinical study[J].journal interventional radiology,2021,30(12):1286-1291.
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经左侧腋静脉近侧段植入输液港穿刺方式临床研究()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
30
期数:
2021年12
页码:
1286-1291
栏目:
临床研究
出版日期:
2021-12-25

文章信息/Info

Title:
Implantation of totally implantable venous access port via left proximal axillary venous approach： a clinical study
作者:
陈天佑;  袁 敏;  杨柏帅;  周 粟;  侯毅斌
Author(s):
CHEN Tianyou;  YUAN Min;  YANG Boshuai;  ZHOU Su;  HOU Yibin.
Department of Interventional Radiology， Affiliated Shanghai Public Health Clinical Center of Fudan University， Shanghai 201508， China
关键词:
【关键词】 完全植入式静脉输液港;  腋静脉;  穿刺术
文献标志码:
A
摘要:
【摘要】 目的 探讨经左侧腋静脉近侧段完全植入式静脉输液港（TIVAP）穿刺方式的可行性、安全性及影响因素。方法 回顾性分析2015年8月至2020年4月在上海市公共卫生临床中心经左侧腋静脉近侧段植入TIVAP的252例患者临床资料。根据不同穿刺方式，将患者分为超声实时导引穿刺组（n=38）、超声定位标记盲穿刺组（n=84）、骨性标志盲穿刺组（n=49）、X线透视定位盲穿刺组（n=41）、静脉造影导引穿刺组（n=40）等5组。分析各组穿刺成功率、穿刺相关并发症发生率及影响穿刺成功率的因素。结果 超声实时导引穿刺组、超声定位标记盲穿刺组、骨性标志盲穿刺组、X线透视定位盲穿刺组、静脉造影导引穿刺组首次1针穿刺成功率，分别为94.7%、82.1%、65.3%、70.7%、75.0%，2～3针成功率分别为100%、96.4%、83.7%、87.8%、92.5%。252例中11例（4.37%）误穿刺动脉，3例（1.19%）发生气胸，无伤口渗血、血胸、腋神经损伤等严重穿刺相关并发症。超声定位标记盲穿刺患者体质量指数（BMI）越小、腋静脉横径越宽、腋静脉距体表距离越短，穿刺成功率越高。腋静脉横径为8.45 mm时曲线下面积为0.782，则Youden指数最大，灵敏度为76.8%，特异度为66.7%，提示腋静脉横径＜8.45 mm时不推荐盲穿刺。 结论 超声实时导引下穿刺腋静脉近侧段成功率高、穿刺相关并发症少。超声定位标记盲穿刺法、静脉造影导引穿刺法是可行的替代方式。临床实践中需根据患者实际情况、术者经验习惯、科室器械配置等灵活选择穿刺导引方式。

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备注/Memo

备注/Memo:
（收稿日期：2020-12-09）
（本文编辑：边 佶）
更新日期/Last Update: 2021-12-21